]]>Here’s one thing I can say about Alberta’s public health care system, without fear of contradiction – everyone has an opinion about what’s wrong with it, and how we should fix it.

Tuesday night, the Alberta Medical Association, and the Edmonton Journal were the co-hosts of a public forum at the University of Alberta Hospital’s Snell Hall, designed to air quite a few of those different perspectives.

Lucinda Chodan, editor in chief of the Edmonton Journal, served as moderator for the Alberta Medical Association/Edmonton Journal health policy forum.

The 400-seat hall was packed for an evening of questions with Progressive Conservative Health Minister Fred Horne, Raj Sherman, an ER doctor and the leader of Alberta’s Official Opposition Liberal Party, Brian Mason, leader of the New Democrats, Danielle Smith, leader of the Wildrose Alliance, and Glenn Taylor, the leader of the Alberta Party.

I was there too, along with my colleagues, Graham Thomson, our provincial affairs columnist, and Jodie Sinnema, our award-winning health reporter. We were supposed to grill the politicians with questions at the end of the evening – but we never got the chance! There were so many people in the audience, with so many questions, we decided to yield the floor to audience, in an effort to fit in as many questions as possible in the course of two hours.

1) Fred Horne – calm, measured, thoughtful and well-spoken, as the government representative, he had the hardest task of the night, under attack from four opposition leaders, and forced to defend the PC health record, dating back decades. Horne’s central point of the evening? That he favours slow, incremental improvements, not monumental change. On the one hand, that’s welcome news, in the sense that our poor health system doesn’t never more major upheaval. On the other hand, given that the PCs have been in power for 40 years, it’s pretty hard to argue that its incremental change is working.

2) Raj Sherman – Sherman was in his element Tuesday night. As a practicing ER doctor, he had facts, figures, and emotional anecdotes at his finger tips. And Sherman shines in the spotlight. He’s a natural performer, an empath, with an innate ability to relate to others on an emotional level. He was the clear audience favourite. A Liberal government, he suggested, would spend more money on long-term care, legislate staff levels in nursing homes and hospitals, and get junk food out of schools. But Sherman failed to explain how he’d pay for such things, or what trade-offs the system might have to make.

3) Brian Mason – Mason was the fire-brand of the evening, occasionally to the detriment of his argument. (At one point, he claimed the New Democrats had created health care (we’re guessing he meant public health care.) He also alleged that Tory MLAs got some kind of preferential access to health care, for themselves and their constituents, an allegation that went unsupported (and, let it be said, unchallenged by any one else.) But Mason also had some of the best lines of the night, including a spirited, and cogent attack on the role of private insurance in the health care system.

4) Danielle Smith – The Wildrose leader chose her words carefully, keen to defuse suggestions that her party wants to privatize health care or move to an American model. Instead, she stressed that the Roses want to look at health care models in other developed countries, that use a blend of private and public dollars – but, she insisted, all within the boundaries of the Canada Health Act. She also called to a return to more local autonomy in health care management (which Horne dismissed, by saying the province couldn’t go back to a 1970s management model.) Smith also talked about setting up personal health savings accounts, a way to save money for future health needs – a system that would either offer tax breaks or some kind of tax shelter. What would such accounts fund? Here, for me, was where Smith went off the rails, praising the system as a way taxpayers could subsidize complementary health care treatments like naturopathy. Really? Do we really want public support for New Age faith-healing? Call me dubious, to say the least.

5) Glenn Taylor – the newest leader, with the lowest public profile, Taylor has no legislative experience. But he handled himself extremely well, injecting some much needed, and appreciated, humour into the evening. He had thoughtful answers about the use of technology in the delivery of rural medicine, in particular. His personal performance was very solid – a mix of Horne’s earnest thoughtfulness, leavened with some of Mason’s passion, and a little welcome wit. But Taylor failed to explain how the Alberta Party’s health platform would be different, in any notable way, from that of the Liberals, or the New Democrats. This was a potential “break-out” performance for Taylor – but not a party still struggling to find an identity.

My major frustration for the evening? Not one of the debaters really discussed the difficult issues of sustainability. Who is going to pay for all this? No one was willing to go anywhere near the issue of health care premiums, tax increases, or a provincial sales tax. No one was willing to talk about deciding what services are essential and which are not. Indeed, Brian Mason even insisted that there was no need for new funding sources, that everything could be accomplished within existing revenues. And no one was willing to talk about extending scope of practice, or changing the way we compensate physicians. All people wanted to talk about was providing more and better service, not how to husband the resources we have.

Don’t misunderstand me. I’m a proud proponent of public health care. But if we want our health care system to be sustainable, we can’t just talk about more and better. We have to talk about smarter and more efficient. And we have to be honest with ourselves. If we want a better health care system, we have to be ready to foot the bill, one way or another.

]]>http://blogs.edmontonjournal.com/2012/03/13/a-health-forum-report-card/feed/0paulaticsLucinda ChodanAMA forumThe number one issuehttp://blogs.edmontonjournal.com/2011/10/05/the-number-one-issue/
http://blogs.edmontonjournal.com/2011/10/05/the-number-one-issue/#commentsThu, 06 Oct 2011 01:44:15 +0000http://blogs.edmontonjournal.com/?p=90773From a CBC story entitled WILDROSE GOVERNMENT WOULD TRY TO BUY AIRPORT FROM EDMONTON:

“Smith said the move is the No. 1 issue in some northern Alberta communities.

“Smith said the move is the No. 1 issue in some northern Alberta communities.

“When we’ve done town hall meetings in High Level, in Lac la Biche, the closure of the Edmonton City Centre Airport and the impact that it is going to have on our northern communities is a constant source of concern,” she said.

Last week, I had the great fortune of flying in a small airplane. I was following the front-runner in the PC leadership race for a profile on his life and ambitions for the province. I mostly hung around and listened to Gary Mar talk, to Globe reporter Josh Wingrove and I, and — far, far more often — to Northern Albertans.

We flew from Camrose to Whitecourt, Whitecourt to St. Paul, St. Paul to the City Centre Airport. No one ever asked for my identification. My belt and my shoes stayed on. There were no wands or X-ray machines or security officials carrying an odd blend of official blandness and anger about them.

It was, in short, a glorious experience. If I had a 6-seat airplane with leather seats of my very own, I would be furious at Edmontonians for this decision they have made.

After Mar spoke, there were questions. Several of them were repeated, in every community. Here they are, in a list of most to least popular.

1. Sustainable municipal funding

2. Public versus private health care

3. Education funding

4. New markets for Alberta oil, to reduce our dependency on the U.S.

5. Replacements for older hospitals

There was one question about the downtown airport in Edmonton. There was also one question about whether or not Mar went to church on Sundays. He answered one question a bit awkwardly, as he had not prepared for it. The other question he answered confidently.

“This is a matter of municipal responsibility. Edmontonians have thought long and hard on this, and they have made their decision. The Alberta Government respects that decision. If there are health impacts, we’ll look closely at that and work with the City of Edmonton to find solutions.”

The man who had asked the question about the Edmonton City Centre Airport, in a community hall in St. Paul, nodded his head: satisfied with the answer.

We flew to Edmonton with Greek takeout. Mar drew a map of China on his styrofoam box of souvlaki, to demonstrate the complexity of the country. We landed and we walked to the terminal; the cars were parked just out front.